SHM Converge Scientific Abstract ePoster Gallery-Gloves Off; An Atypical Presentation of Self-Inflicted Penile Degloving Under the Influence of Cocaine

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This case report describes a rare self-inflicted penile degloving injury in a 41-year-old man with polysubstance use, depression, and bipolar disorder. After prolonged masturbation while under the influence of cocaine, he developed worsening penile pain and progressive skin breakdown over five days, including a superficial ulcer that turned greenish. On exam, he had circumferential degloving of the penile midshaft extending proximally, but the scrotum, urethral meatus, and deeper tissues were intact. He had no systemic signs of infection.<br /><br />Laboratory testing showed no major leukocytosis or evidence of sexually transmitted infection, hepatitis, HIV, syphilis, or autoimmune disease. Urine toxicology was positive for cocaine, opiates, and THC. He was admitted and started on broad-spectrum antibiotics. Surgical debridement found denuded penile skin with minimal superficial necrosis, healthy underlying dermis, and no urethral, scrotal, or deep tissue involvement. Superficial wound cultures grew MSSA and Streptococcus pyogenes, so antibiotics were narrowed to IV cefazolin. A split-thickness skin graft from the right thigh was placed, and the patient improved and was discharged with outpatient urology and wound care follow-up.<br /><br />The report emphasizes that penile degloving is a rare soft-tissue injury usually associated with trauma, machinery accidents, animal bites, or penile devices, but clinicians should also consider it in the setting of substance use and high-risk sexual behavior. Diagnosis is primarily clinical, and treatment requires debridement of nonviable tissue, with split-thickness skin grafting often needed for reconstruction.

Asset Subtitle

Zohaib Ahmad

Meta Tag

Author List Jorgio Auguste, Junaid Khan, Kevin Rulka, Michael Lim, Priyanka Bhandari, Richard Schoor, Victoria I. Oriuwa, Zohaib Ahmad

Category Clinical Vignettes

Concept Penile Degloving

Concept Skin Loss

Concept Physical Examination

Concept Debridement

Concept Split-Thickness Skin Graft

Distinguished Non-Finalist

Presenter Organization NYU Langone Health Suffolk Hospital

Presenting Author Zohaib Ahmad

Track Adult

Keywords

penile degloving

self-inflicted injury

cocaine use

polysubstance abuse

masturbation

skin graft

surgical debridement

penile trauma

Streptococcus pyogenes

Staphylococcus aureus

Penile Degloving

Skin Loss

Physical Examination

Debridement

Split-Thickness Skin Graft